title: Premature coronary heart disease in SLE: can we prevent progression?
abstract: Patients with systemic lupus erythematosus (SLE) have a higher prevalence of clinical and subclinical atherosclerosis compared with age- and sex-matched controls. Atherosclerosis progression is also accelerated in SLE, and coronary heart disease (CHD) is a major cause of morbidity and mortality. Traditional cardiovascular (CV) risk factors, including hypertension, diabetes mellitus or dyslipidemia, are more prevalent in SLE patients than in the general population, but they cannot fully account for accelerated atherosclerosis in SLE. In fact, a number of nontraditional risk factors have been identified, including disease activity, damage and various treatments. Preventive strategies for CHD are mandatory in SLE patients and should include giving up smoking; performing regular physical activity; managing metabolic abnormalities such as dyslipidemia, insulin resistance, and diabetes; treating persistent disease activity; and minimizing chronic exposure to corticosteroids. Low-dose aspirin, angiotensin-converting enzyme (ACE) inhibitors, vitamin D supplementation, antimalarials and, when indicated, some immunosuppressants such as mycophenolate mofetil should also be considered.
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Iaccarino
authors.forename: S
authors.initials: S
authors.lastname: Bettio
authors.forename: M
authors.initials: M
authors.lastname: Zen
authors.forename: L
authors.initials: L
authors.lastname: Nalotto
authors.forename: M
authors.initials: M
authors.lastname: Gatto
authors.forename: R
authors.initials: R
authors.lastname: Ramonda
authors.forename: L
authors.initials: L
authors.lastname: Punzi
authors.forename: A
authors.initials: A
authors.lastname: Doria
mesh_terms: D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008019:Life Style; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D005938:Glucocorticoids
keywords: Systemic lupus erythematosus; coronary heart disease; premature atherosclerosis; prevention